Vitamin D3 Adjuvant Treatment Stimulate Interleukin-10 Expression in Children with Nephrotic Syndrome Without Affecting to Clinical Outcome and Glucocorticoid Receptor Expression

Idiopathic nephrotic syndrome (INS) is the most glomerular disease that occurred in childhood with high rate morbidity. Glucocorticoid is drug of choice for INS and responsiveness to this drug determined prognosis. Glucocorticoid upregulate transcription of anti-inflammatory cytokines such as IL-4 and IL-10. IL-10 is an anti-inflammatory cytokine and has multiple role in immune response include modulate Th1/Th2 response. Vitamin D3 interact with glucocorticoid signaling. Administered active form of vitamin D3 increase dexamethasone-induced IL-10 expression by regulatory T cells in steroid resistant asthmatic patient. Here we showed increase of CD4+IL10+ expression after treatment both prednisone only and combination prednison with vitamin D3. Both in new-onset NS or rare relaps NS, combination treatment prednisone + vitamin D3 increase CD4+IL10+ expression significantly compared to prednisone-only treated group (p= 0.003), which first group (new-onset nephrotic syndrome + prednisone and vitamin D3 treatment) showed the most CD4+IL10+ expression enhancement (9.533.89). However this study failed to show a correlation between CD4+IL-10+ expression after prednisone and vitamin D3 treatment with clinical outcome (linear regression test, p= 0,125). This study also showed that there was a no correlation between CD4+IL-10+ expression and CD3+GR expression after prednison + vitamin D3 treatment (p= 0.088). CD4+IL-10+expression in new-onset and rarely relapsing nephrotic syndrome patients higher in prednisone + vitamin D3 treated group than prednisone-only treated group. There is no correlation between CD4+IL-10+expression and CD3+GR expression nor CD4+IL-10+expression and clinical outcome

Level of 25(OH)D Serum, Expression of Interleukin 4 and Glucocorticoid Receptor of Mononuclear Cell in Steroid Resistance Nephrotic Syndrome Children

Nephrotic syndrome (NS) is autoimmune disease and its steroid resistance status supposed correlate with 25(OH)D level and IL-4 expression. The aimed of this study was investigated 25(OH)D plasma level, IL-4 and GR expression of PBMC in steroid sensitive and resistant pediatric NS patients and the association of those parameters. 27 subjects were divided into three groups (control group, steroid resistant NS group, and steroid sensitive NS group). Peripheral blood mononuclear cells (PBMCs) isolated using Ficoll-Hypaque method. Plasma 25(OH)D level was measured using ELISA method. IL-4 and GR expression were measured using flowcytometry of PBMCs. This study showed that 25(OH)D level and GR expression were significantly different in control group compared to steroid resistant NS group (p<0.05). Plasma 25(OH)D level, IL-4 and GR expression were not correlated each other in NS patients (p>0.05). Plasma 25(OH)D level, IL-4 and GR expression were not contributed in steroid resistance in NS patients. However, GR expression has highest contribution in steroid resistance of NS patient (Wald score 1.198). Plasma 25(OH)D level and GR expression was lower in steroid resistant NS group. GR expression has a highest contribution in steroid resistance of NS patients

The Correlation Between Serum Concentration of Vitamin D with Vitamin D Receptor Expression and Disease Activity in Indonesian Patients with Systemic Lupus Erythematosus: Preliminary Study

The vitamin D role on the immune response of systemic lupus erythematosus (SLE) patient is mediated by vitamin D receptor (VDR). Low level of vitamin D correlated with disease activity in SLE patients, and circulating levels of activated vitamin D (1,25(OH)2D) contribute to VDR protein levels and its function. The objective of this study was to determine the correlation between vitamin D status with expression of VDR in peripheral blood mononuclear cell (PBMC) and the disease activity in SLE patients. The Research Subjects were 15 SLE patients (ACR 1997 criteria) from the Rheumato-Immunology Division, dr. Saiful Anwar Hospital, Malang and 5 healthy controls. Serum vitamin D (25(OH)D3) level was assessed using ELISA method. VDR expression in PBMC was assessed using immunocytochemistry technique. The disease activity was measured by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. This study showed no difference on VDR expression in PBMC between patient and healthy control group, but patient with vitamin D deficiency had lower VDR expression in PBMC than the other group. No difference on SLEDAI score between the group. Vitamin D status correlated positively with VDR expression in PBMC (p < 0,035, r = 0,473). However vitamin D status did not correlate with disease activity scores (p = 0,686)

Pengaruh Pemberian Kalsium Terhadap Pertumbuhan Plasmodium Falciparum in Vitro

Peningkatan permeabilitas sel eritrosit yang terinfeksi Plasmodium falciparum terhadap ion dan makromolekul diketahui sebagai mekanisme parasit untuk memenuhi nutrisi dalam proses pertumbuhan. Peningkatan permeabilitas terhadap kalsium masih merupakan hal yang kontradiktif dalam peranannya meningkatkan pertumbuhan Plasmodium falciparum dalam sel eritrosit. Tujuan dari penelitian ini adalah mengetahui peningkatan pertumbuhan Plasmodium falciparum dalam sel eritrosit pasca pemberian kalsium. Biakan primer Plasmodium falciparum dalam medium biakan RPMI 1640 yang menghasilkan parasitemia 15%, dilakukan inokulasi untuk pembuatan subkultur yang menghasilkan parasitemia 2% dan dilakukan pembagian untuk kelompok perlakuan pemberian kalsium dan kontrol (ML 10%) dengan replikasi 3 kali. Pengamatan dilakukan hari pertama sampai hari ke-6 setelah perlakuan. Pengamatan pertumbuhan dilakukan dengan parameter parasitemia, bentuk skizon, hemolisis dan kalsium intraseluler. Hasil penelitian menunjukkan bahwa pemberian kalsium menghasilkan peningkatan tertinggi jumlah total rerata parasitemia (11,09 ± 4,01) (Rerata ± SD), bentuk skizon (23,52 ± 10,83), hemolisis (0,278 ± 0,03) dan kalsium intraseluler (6,55 ± 1,88), dibandingkan dengan media biakan kontrol (ML 10%). Analisis T-test (α= 0,05) menghasilkan perbedaan yang signifikan pada parameter parasitemia, bentuk skizon, hemolisis tetapi tidak memberikan perberbedaan yang signifikan pada parameter kalsium intraseluler

Prominently Increased of Mannose Binding Lectin (MBL) and Myeloperoxidase (MPO) Levels in Severe Valve Regurgitation and Heart Failure of Rheumatic Heart Disease

Rheumatic heart disease (RHD) is mediated by an abnormal immunological response following a Streptococcus pyogenes infection that induces a disturbance of oxidants and antioxidants balances. Mannose-binding lectin (MBL) binds to N-acetylglucosamine, a molecule present on the Streptococcus cell wall and human heart valves. There is a disturbance of oxidant and antioxidant balance in rheumatic disease. Myeloperoxidase (MPO) is a marker of oxidative stress and inflammation. This study was aimed to determine the correlation of MBL and MPO levels and severity of valvular regurgitation and heart failure (HF) in RHD patients. A case-control study was conduct using human peripheral blood samples from 32 children aged 6 to 14 years old. The subjects were divided into two groups: 16 RHD patients included in the case group and 16 healthy children as a control group. The level of MBL and MPO was investigated using ELISA method. There were significant differences on MBL and MPO level between patient and control group. The level of MBL and MPO were significantly increased in RHD group, especially on severe valvular regurgitation. There was a strong correlation between MBL and MPO levels and the severity of valvular regurgitation (r = 0.94 and r = 0.88). The least significant diff-erence (LSD) analysis showed that significant difference occurs in the severe heart failure group. Our research revealed that the MBL and MPO levels in pediatric RHD patients were significantly higher than in healthy children. The MBL and MPO levels were significantly correlated with the severity of valvular regurgitation and heart failure